A major reform to Ireland’s organ donation laws comes into effect today as the first phase of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Act 2024 is officially enacted. The new legislation introduces a soft opt-out system for organ donation and is intended to increase the availability of organs for transplantation while placing consent at the heart of all related processes.
Under the new system, all adults aged 18 and over will now be presumed to have consented to donate certain organs after death unless they have explicitly registered to opt out. The change applies to five specific organs defined as “relevant organs” under the Act: the heart, lungs, liver, pancreas, and kidneys. Individuals who do not wish to donate these organs must register their decision with the Relevant Organ Donation Opt-Out Register, maintained by the Health Service Executive (HSE).
Crucially, even under the new system, loved ones will continue to be consulted before any donation proceeds. The law introduces the concept of a “designated family member” — the person who will be asked to confirm the deceased’s wishes or provide consent if no objection has been registered. In most cases, this will be the individual who had the closest contact with medical staff during the person’s final care. If such a person cannot be identified, a hierarchy outlined in the legislation will determine who is consulted.
Another significant change introduced today is the legal framework for non-directed altruistic donation. This means that for the first time in Ireland, a living person may choose to donate a kidney to someone they do not personally know. Applications for such donations will be assessed by an Independent Panel to ensure the donor is fully informed and freely giving consent, with additional protections in place.
The government hopes the new system will help address the chronic shortage of donor organs in Ireland. At any given time, around 600 people are on waiting lists for transplants. By aligning with international best practices and shifting toward a system where consent is presumed but still respectful of individual and family decisions, the legislation aims to expand the donor pool while preserving personal autonomy.
The Human Tissue Act 2024 was signed into law in February and is being implemented in phases. Today’s commencement covers the provisions related to organ, tissue, and cell donation and transplantation. Other parts of the Act — including those related to post-mortem procedures, anatomical examination, and public display of human remains — will be brought into force at a later date.
Health authorities are encouraging members of the public to discuss their donation preferences with family and friends, regardless of whether they choose to remain in or opt out of the donor pool. While registering a decision is important, ensuring that family members are aware of a person’s wishes remains a vital part of the process.
Further information, including how to opt out or learn more about living donation, is available through the HSE’s official website at www.hse.ie/organdonation.
